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Objective: To measure the extent to which pharmacist-patient conversations are private. Design: Cross sectional. Setting: New York State, April to June 2007. Participants: No individual participants were enrolled: the study consisted of observations of the pharmacy environment and pharmacy patient-staff interactions. Intervention: Measurement of privacy-related distances in the pharmacy. Main outcome measures: Distance between patients at the pharmacy counter and staff behind the counter, distance between patient waiting area and pharmacy counter, and distance that a pharmacy counter conversation was audible. Results: Observational data were recorded from 597 pharmacy staff-patient interactions in 282 pharmacies across New York State. Of the 597 interactions, 167 occurred while a second patient was within 6 ft. Of the 282 pharmacies, pharmacy staff-patient conversations were audible to observers more than 6 ft away in 229 pharmacies; 142 could be heard more than 15 ft away. Conclusion: Most staff-patient conversations in the pharmacy setting are not private and, as a result, have a high potential for incidental protected health information disclosures. [ABSTRACT FROM AUTHOR]